Physician Assistant Genitourinary and Renal System Disorders 5

Question 1

A 60-year-old smoker has painless gross hematuria. What is the most appropriate evaluation?

Accepted Answer

Cystoscopy and CT urography

Answer

Painless gross hematuria in a smoker requires cystoscopy and upper tract imaging to rule out urothelial carcinoma.

Question 2

Which classic triad is associated with renal cell carcinoma, though present in only a minority of patients?

Accepted Answer

Hematuria, flank pain, palpable flank mass

Answer

Hematuria, flank pain, and a palpable mass form the classic but uncommon RCC triad.

Question 3

Renal cell carcinoma may cause erythrocytosis through ectopic production of which substance?

Accepted Answer

Erythropoietin

Answer

RCC can secrete erythropoietin, producing secondary polycythemia as a paraneoplastic syndrome.

Question 4

A 65-year-old man has nocturia and weak stream. Which medication improves symptoms and can reduce prostate size over months?

Accepted Answer

Finasteride

Answer

5-alpha-reductase inhibitors like finasteride shrink the prostate and lower PSA by about 50%.

Question 5

A 35-year-old man has fever, perineal pain, dysuria, and an exquisitely tender boggy prostate. What should be avoided?

Accepted Answer

Vigorous prostatic massage

Answer

Prostatic massage in acute bacterial prostatitis is contraindicated as it may cause bacteremia.

Physician Assistant Practice Test